SUJATA PRAMOD PRABHU MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000308

License Status

EXPIRED

Business

Title

First Name

SUJATA

Middle

PRAMOD

Last Name

PRABHU

Business Name

SUJATA PRAMOD PRABHU MD

Original Issue Date

02/15/2008

Effective Date

02/15/2008

Expiration Date

08/14/2008

City

GRANITE CITY

State

Zip

62040

County

MADISON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/05/2008